Zenas Kuate Defo, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

062908 Issued in NY

Practice address

St Regis Mohawk Tribe Health Services
404 State Route 37
Hogansburg, NY 13655-3109

Phone

(518) 358-3141

Fax

(518) 358-9175

NPI assigned

Apr 30, 2021

Last updated

Dec 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Regis Mohawk Tribe

  dba St Regis Mohawk Health Services

  • Federally Qualified Health Center (FQHC)
  • Akwesasne, NY
  • NPI 1457344558
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1801479514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141",
            "fax_number": "518-358-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST REGIS MOHAWK TRIBE HEALTH SERVICES",
            "address_2": "404 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141",
            "fax_number": "518-358-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUATE DEFO",
        "first_name": "ZENAS",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Pyke (Mohawk Vision)
• Louise D Ingle, L.P.N.
• Sharon Anne Jackson, LPN
• Kawenniio Jamaica Johnson, RN
• Trish D Keese, CASAC 2
• Nancy J Labarge, RN
• William R Latreille Jr., M.D.
• Erica L Legrow, LPN
• Michael William Lynch, M.D.
• Verda Marie Lyons, RN

• Dentist in Hogansburg, NY
• Providers in Hogansburg, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.